臨床検査59巻7号

2015年07月発行

今月の特集1 検査と臨床のコラボで理解する腫瘍マーカー

PSA—検査編

著者： 石橋みどり¹

所属機関： ¹新東京病院臨床検査室

ページ範囲：P.644 - P.654

Point

●前立腺特異抗原（PSA）の分子多様性が前立腺癌マーカーとしての特異性を示す．

●測定試薬はfree PSAとPSA-ACTに対してequimolar assayであることが必須である．

●キットキャリブレータの値付けは，WHO 1st International Standard（96/670）またはfree 100％ Standard（96/668）が望ましい．

●測定値の変動要因を把握する．

参考文献

1）Wang MC, Valenzuela LA, Murphy GP, et al：Purification of a human prostate specific antigen. Invest Urol　17：159-163，1979

2）原三郎，井上徳治，山崎春夫，他：ヒト精漿の法医免疫学的研究．日法医誌　21：315，1967

3）Hans Lilja，加野象次郎：Prostate-specific antigen（PSA，hK3）とHuman glandular kallikrein 2（hK2）の生理化学と病態生理学．泌外　11：902-905，1998

4）Mikolajczyk SD, Millar LS, Kumar A, et al：Human glandular kallikrein, hK2, shows arginine-restricted specificity and forms complexes with plasma protease inhibitors. Prostate　34：44-50，1998

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9）Björk T, Bjartell A, Abrahamsson PA, et al：Alpha 1-antichymotrypsin production in PSA-producing cells is common in prostate cancer but rare in benign prostatic hyperplasia. Urology　43：427-434，1994

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14）Agha AH, Schechter E, Roy JB, et al：Prostate specific antigen is metabolized in the liver. J Urol　155：1332-1335，1996

15）Bernard C：PSA Testing　The Disconnect Between Standardization and Interpretive Criteria. Clinical Laboratory News, 2008

16）Stephan C, Kahrs AM, Klotzek S, et al：Toward metrological traceability in the determination of prostate-specific antigen (PSA): calibrating Beckman Coulter Hybritech Access PSA assays to WHO standards compared with the traditional Hybritech standards. Clin Chem Lab Med　46：623-629，2008

17）石橋みどり，加野象次郎：血清総PSA測定の標準化　国際的動向とわが国における標準化への取り組み．臨検　49：975-980，2003

18）Woodrum D, French C, Shamel LB：Stability of free prostate-specific antigen in serum samples under a variety of sample collection and sample storage conditions. Urology　48(6A Suppl)：33-39，1996

19）Sokoll LJ, Bruzek DJ, Dua R, et al：Short-term stability of the molecular forms of prostate-specific antigen and effect on percent complexed prostate-specific antigen and percent free prostate-specific antigen. Urology　60(4 Suppl 1)：24-30，2002

20）石橋みどり，加野象次郎：PSA測定における諸問題．泌外　13：948-953，2000

21）加野象次郎，石橋みどり：前立腺特異抗原（PSA）の遊離型と結合型の各種検体保存条件下における安定性に関する検討．協栄生命健事業団研助成論集　15：1-8，1999

22）Andriole GL, Marberger M, Roehrborn CG：Clinical usefulness of serum prostate specific antigen for the detection of prostate cancer is preserved in men receiving the dual 5alpha-reductase inhibitor dutasteride. J Urol　175：1657-1662，2006

23）阿部正樹，俵木美幸，佐藤亮，他：数種のイムノアッセイ法においてPSA偽低値を呈した前立腺癌患者血清の検討．日臨検自動化会誌　33：805-811，2008